Recent work on this project has: (1) described current pain management practice for a large number of health care professionals, identified their perceptions of why patients are poorly treated, and determined characteristics of physicians more likely to undertreat pain, (2) examine the prevalence, severity and treatment of pain in a large sample of cancer patients and identified patient risk factors for undertreatment of pain, (3) defined major patient-related barriers to pain control in cancer and demonstrated their impact on the care patients receive, (4) pilot-tested patient educational methods for reducing patient related barriers to care, (5) piloted method for testing interventions to improve pain control in collaborative clinical trials groups, and (6) demonstrated the feasibility of international studies of pain and pain treatment, and the utility of such studies for assessing and treating U.S. cancer patients. The research goals of this funding period continue to be the identification and reduction of barriers to pain relief. These studies will: (1) examine the status of pain management in minority groups, (2) evaluate patient-related barriers in special populations, (3) examine the effect of caregiver concerns on adequacy of pain management, (4) test educational and behavioral interventions for pain relief in clinical trials, and (5) continue international studies of cancer pain and its treatment and field-test methods of modifying health care practice of cancer pain management in situations with limited medical sophistication and resources. The studies described will continue to make use of established collaborations with the Wisconsin Cancer Pain initiative, the World Health Organization, and the Eastern Cooperative Oncology Group.